TED Talk: Sebastian Junger "Our lonely society makes it hard to come home from war"

Today we watched a TED Talk about PTSD and its causes. Sebastian Junger states that he had a minor case of Temporary PTSD when he came home from a trip to war, but ended up having it go away rather quickly. The problem is, however, when soldiers come back from war and they end up with chronic PTSD that lasts for years and years, and the rates seemed to be going up.

TED Talk Sebastian Junger 

Junger concluded that the PTSD rates that were going up weren't from more trauma, but by how the soldiers were treated when the war was over. He thought over the Apaches and Cherokee Indian tribes that he had studied in college and wondered why the rates of PTSD hadn't been high in these nations that battled frequently with the US or other tribes. He decided that the reason was because they went home to a tribe that understood what they'd been through. He realized that since these soldiers were leaving their close knit platoon to a lonely society, they were going to have higher rates of trauma that might not actually be there. He says that depression in society goes up the wealthier people are because people lose those bonds. After 9/11 people all bonded over that trauma, so soldiers were less traumatized after war during the time the country was unified. Now that the country is starting to break apart again, people are experiencing more long term PTSD.

Depression in Young People

These are notes taken about a webinar by the National Institute of Mental Health. This is a review of everything talked about during the webinar. 

Why is there Depression?

Sadness and depression can be an evolutionary protection device from negative outcomes. It may be a physic pain or a way of changing one's environment. There may be positivity to negativity. It may be a protection from infections or how we focus on the past (an analytical rumination of thinking).

Is this sadness or depression? For about 3 weeks, a girl named Christina's mood is low, she spends her time alone. Her grades are lowering and she cannot concentrate. Her parents separated very recently.

Five of the following symptoms are present for two or more weeks:

Depressed mood for most of the day, or irritable mood, it has to be present most of the time
Markedly diminished interest or pleasure at all
Significant change in weight when not dieting or weight gain
Insomnia or Hypersomnia
Psychomotor agitation or retardation
Fatigue or loss of energy nearly every day
Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day
Diminished ability to think or concentrate
Recurrent thoughts of death (not just fear of dying) recurrent suicidal ideation without a specific plan or an attempt or specific plan to commit suicide

The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning

Prevalence

10-17% In adults
1-2% in pre-pubertal children
Adolescents with depression are 30% more likely to die of suicide
In its severe form, it affects 9% of adolescents
Second leading cause of people living with disability
More prevalent than other diseases, even cancer

Genes and Environment: Potential Causes

Genes: 30-50% of the liability to depression
Gene-environment correlation: e.g. Increased genetic liability for lifetime traumas
Gene-environment interaction: different genotypes respond to environmental variability in different ways

Ex. Christina's mother is diagnosed with depression during pregnancy. It may pass down to the child. Christina's father lives far away and sees her rarely. He drinks and his company went bankrupt. Since Christina shares genes with both of these people, she has a higher liability in having depression. They also experienced traumatic events, which may affect her more. But since they are correlated, they may end up working together passively or actively. Ex: Since Christina's mother is depressed, they may both become depressed since they share the same genes and experiences.

Dr Kendler used a study on identical and fraternal twins to see how much environment affects liability. Having a traumatic life event increases the chances dramatically. The lowest chances are the ones with genetics that don't react as strongly. The opposite leads to a higher chance of depression in the presence of a life event. So some people may have completely different reactions to the same event.

With the onset of puberty, girls are more likely to have depression than boys. There is a 1 to 2 ratio. It may have to do to with cognitive processing, greater exposure to psychological stressors, or hormonal mechanisms. Girls with an earlier start in their menstrual cycle are more likely to become depressed, it may be because of hormones, or a psychological stressor, or over exposure to other people, they feel uncomfortable around.

There is a debate on whether childhood depression correlates with adult depression, but adolescent depression has shown pathways to adult depression.
Anxiety: early on anxiety precedes depression
Alcohol: Probably an "internalising" way of handling depression
ODD/CD: The strongest predictors for later depression
Behaviour problems and depression are related
40% had disruptive behaviour in their childhood
Highest risk in girls
Youth with CD are twice more likely to have it
Irritable and disruptive behaviour are shown to be directly correlated. What we need to find out is how this transition starts and finding out who has depression and who doesn't.

Depression is a heterogeneous syndrome. It is useful to think of two abnormalities

-Negativity bias and missing the positive
It is more common for someone with anxiety or depression to misinterpret a neutral face as sad or angry.
-They will pick up what is negative in their environment
They will be more likely to miss the positive, such as a smile. A depressed person will relate a smile back to positive less than someone else. Anti-depressants work highly in these areas.
Motivation and reward processing
-Most people go after rewards and feel good when they get it
Anticipatory anhedonia: People with depression will not take the effort to get that reward
People will see this as lazy or a motivation problem, but with depression, it is more that the person can't see why this would be important
Ex: Christina used to dance, but she stopped because they are "no fun at all" She has stopped sending texts to her friends.
People with no processing in the longitudinal segment of the brain are more likely to be depressed in life; this is the segment of the brain that has reward processing.

Phycological and Medical Treatments

Christina's diagnosis was delayed for 18 months. Why?
Parents focused on irritability/oppositionality
Teachers focused on academic performance
She herself could not talk about it, except in terms such as "boring", "annoying" etc.
She was only diagnosed after she took her first overdose and then it became apparent that she had been "cutting" for a while.
It was still hard to explain to her parents the meaning of the problem
She herself was still perplexed

Awareness is key to diagnosis.
Screening is only appropriate in samples that are at high risk. Screening can range from single questions to a questionnaire. Diagnosis should also address the presence of manic symptoms, underlying medical causes (rare), risk assessment, such as past attempts of suicide and cases of depression. They shouldn't have access to guns or drugs.

Not all causes are changeable, such as environment or genes. You may be able to change the relationship between the mother and child or the father and child. Medication can have an effect on behaviour, feelings, and thoughts through the brain, but so does psychological treatments.

The first treatment is a reuptake in serotonin, fluoxetine, sertraline, citalopram
Psychological treatments such as interpersonal treatment or cognitive therapy

There haven't been any sign that one is better than the other. In mild cases, start with CBT/IPT
Some studies show that using them both may be the best
About 60% of young people respond to an antidepressant, however, 50% respond to placebo. This may be related to the severity of the depression, the higher the severity of the depression, the lower they affect to placebo.
The numbers needed to treat a person are 10 and the numbers needed to harm is 112. This is particularly important in the context of suicidality debate and the black box warning.

Guest Speakers: Alcoholics Anonymous

This week, guest speakers from Alcoholics Anonymous, a non-profit dedicated to helping people get sober, came to talk to us about their organization and what to do if we ever come across a situation involving alcoholism. Alcoholics Anonymous is an organization that involves meetings with other people with the same problem. Each meeting is different, led by different people so they do different things. People with alcoholism problems can find help through the program, only having to pay for individual meetings, and not being forced to do anything they don't want to. Alcoholism is a constant struggling disease, people with it have trouble not going back to their old habits. It can change the way you think about life, ruin relationships and cause serious damage to your life. Alcoholics Anonymous also has programs for people who know alcoholics so they can help themselves and the alcoholic. If you feel that you are falling into a routine that involves drinking uncontrollably, or you know someone who does, see if there's an AA meeting fitting your demographic near you.

A Glass of Water

Emily Gonzalez

Neto

Tucker

12/6/16

A Glass of Water

Eyes opened, light flooded into my eyes. The doors slammed into the wall, my eyes fluttering open with it. A foggy image of reality fell around me. I heard mumblings, they sounded like my mother, and the doctor. I reached my hand to wipe away at my puffy eyes. Even as I blinked, nothing seemed to stay in focus. I waddled a little while getting up, and the sounds of speech bounced through my ear, bouncing across the inside of my skull, falling down to my throat. My eyes heated up, I choked back my food. I breathed hard, hoping the others didn’t notice, then sat back.

My mom reached for my hand. I smiled. I still couldn’t see every line of her face, but I could feel the warmth in her hand. The doctor was still speaking. I managed to catch a few words, even if they were all just falling to my stomach. More treatments, a surgery. He said it wouldn’t be long before we got out of here. It cheered me up, very little. I could finally stop stealing away all of our money, my future, my life back at home. I could go home, to a warm bed with plush bears and pillows. I could get back to school work, something I’d never thought I’d say positively.

My heart beat a little faster. I noticed that the feeling wasn’t going away, I still felt as if two text books were being pushed against each of my ears, the bed was floating in the ocean, and clouds were over my eyes. I started to yawn, but almost gagged. I clenched my stomach. They looked at me, so I tried to say I was okay. I was trying to wrap my tongue around the words, but just signaled it with my hands. They went back to talking.

That’s when I noticed the glass of water next to me, from the night before. There was food, sure, but I didn’t want to put that in my stomach, it already had enough knots in it, I didn’t need more. The glass was out of reach, but if I got it the other day, I could get it now. I lifted my arm up, but my mom talked to me again. She pointed at the food, but I rolled my eyes and shook my head. I could tell my mom was stern, pointing at the food. I sighed and grabbed a fork, and my mom sighed before going back to talking about prices and insurance and the whatnot, something I wasn’t old enough to understand, or at least that’s what she told me when I asked about it. I kept on looking back at the glass. I put a roll in my mouth, which felt more like a sponge that took in all my built-up saliva. I sniffed and wiped away the tears my eyes kept on making.

Even if all I could focus on was a glass of water, it was something. My focus kept on going from my mom, to the doctor, to the background, to the window that led to the world I hadn’t seen in days, weeks now? How long had it been? Why, why couldn’t I remember...why wasn’t I speaking? Had something gone wrong, what was going on? I reached for breath. Heart beats pushed at my ears so hard my eyes were watering, there was bread at the back of my throat. I gasped for air.

My dry lips stung. I lifted my arm to grab the glass. No one saw. I pushed myself over, noticing my wobble, my eyes refocusing. I did it again, again, until I was sure the bread would spill out of my mouth any minute. I reached up to the glass. I put my hand around it. I put all my energy to move every finger, every bone, until they fit around. Wait, why was I overthinking this? It was just a glass? I took in a deep breath, letting a few tears fall. I took advantage that they still hadn’t seen. I pushed my palm against the glass, then pulled back. That’s when all my attention went into the glass. My fingers...they weren’t working. In a split second, I had lost control. The glass slipped, I felt the cold run through my fingers like silk. My heart stopped when I couldn’t feel it anymore, when gravity took its toll. The shattered glass punctured my inner ears, bursting my brain. The mosaic of a mess painted the floor. My tears weren’t distinguishable from the water.

That’s when they turned back. I jumped back. I held my head in my hands, warming them with wet tears. I couldn’t look at them. My mom moved closer, trying to comfort me, I pushed her back. The doctor called for someone to clean the mess. He tried to comfort me too, but I pushed him back too. I held my head in my hands again, trying to find comfort in the home that was my mind, my, my mind. The mind that couldn’t even lift a glass. Would I ever be able to lift one again?

When time died down my shock, when the glass was gone, and when the room was silent, I finally answered them. I pushed at my chest, trying to get the air to talk, “I-I w-was thirsty.”

They said they could have given it to me. I looked down at the ground, realizing that they thought I was upset at breaking the glass. They got me another glass. They were giving all their attention to me. Pins pierced the back of my neck as I looked up at them. Eyes watering, my back tingling, with a foggy mind and clouded eyes, and stomach that wouldn’t hold. I smiled. I even laughed.

“Don’t worry, it was just a glass of water…”

Works Cited

"Medulloblastoma." St. Jude Children's Research Hospital. N.p., n.d. Web. 07 Dec.                       2016.

"Cerebellum." Cerebellum Function, Anatomy & Definition | Body Maps. Healthline, 5 Mar. 2015. Web. 07 Dec. 2016.

Foundation, Brain Science. "Coping With Personality and Behavioral Changes." Coping With Personality & Behavioral Changes. Brain Science Foundation, 2003. Web. 07 Dec. 2016.

TED Talk - Mysterious Workings of the Adolescent Brain

Sarah Jayne Blakemore
15 years ago, we considered mental development to happen in the first few years of life. Thanks to MRI, we can take a "snapshot" of the brain at different ages. We can use functional MRI to take a video. This has radically changed how we see brain development. Adolescence is actually the age where major brain development happens. The pre-frontal cortex is much bigger in humans, and does cognitive functions, inhibiting inappropriate behavior, social interaction, self awareness. This goes through a dramatic change in adolescence. Grey matter peaks at the age of puberty. Then it goes down, which means that synapses (connections in the human brain) strengthen and others are thrown out. It fine tunes ideas.
Humans are great at reading body language and translate it into human emotions. The Medial Pre-frontal Cortex, is more active in adolescents than in adults when they make social decisions.
Adolescents have been stereotyped, and there are reasons why:
Risk-taking: Especially in groups, adolescents are more likely to take risks. The Pre-frontal Cortex is still in development, and it stops risks. Another part of the brain is still large, and it rewards risk.
Poor impulse control
Self-consciousness

Guest Speaker - Jennielynn Holmes

Today, a guest speaker named Jennielynn Holmes, director of Shelter and Housing in Sonoma County, came to speak to us about homelessness. She told us about how Sonoma County has a homelessness 3x higher than anywhere else in the country, but we have been steadily decreasing that number. It has gone down 30% in the last few years. Still, about 3,000 people live on the streets every night in Sonoma County. 60% of these people live in Santa Rosa, the others in other large urban areas.
A majority of the homeless population is a lot different than what people assume it's like. A large part of these people are families or veterans. All of these people don't have easy access to what we take for granted. Any number of these people start out with or develop mental health issues, which relates to our mental health unit. It is very difficult for these people to get back up on their feet with these problems, or for them to handle their mental issues if they have to worry about where they will sleep or what they'll eat.
The charity that Holmes works at, Catholic Charities of Santa Rosa, does outreach to give homeless people housing. Holmes says that the best way to counteract homelessness is with housing. N.E.W. also wants to help by providing Homeless Packs, just like Innovation STEM did last year. We will work together to make as many packs as possible with business cards for Catholic Charities. Catholic Charities also takes donations, so even you can help by donation to them.
Create your own homeless packs and help break down the stigma that surrounds homelessness!